title: The burden of chronic diseases in a rural North Florida sample.
abstract: BACKGROUND
  The degree of health disparities present in rural communities is of growing concern and is considered "urgent" since rural residents lag behind their urban counterparts in health status. Understanding the prevalence and type of chronic diseases in rural communities is often difficult since Americans living in rural areas are reportedly less likely to have access to quality health care, although there are some exceptions. Data suggest that rural residents are more likely to engage in higher levels of behavioral and health risk-taking than urban residents, and newer evidence suggests that there are differences in health risk behavior within rural subgroups. The objective of this report is to characterize the prevalence of four major and costly chronic diseases (diabetes, cardiovascular disease, cancer, and arthritis) and putative risk factors including depressive symptoms within an understudied rural region of the United States. These four chronic conditions remain among the most common and preventable of health problems across the United States.
  
  
  METHODS
  Using survey data (N = 2526), logistic regression models were used to assess the association of the outcome and risk factors adjusting for age, gender, and race.
  
  
  RESULTS
  Key findings are (1) Lower financial security was associated with higher prevalence of cardiovascular disease, arthritis, and diabetes, but not cancer. (2) Higher levels of depressive symptoms were associated with higher prevalence of cardiovascular disease, arthritis, and diabetes. (3) Former or current smoking was associated with higher prevalence of cardiovascular disease and cancer. (4) Blacks reported higher prevalence of diabetes than Whites; Black women were more likely to report diabetes than all other groups; prevalence of diabetes was greater among women with lower education than among women with higher education. (5) Overall, the prevalence of diabetes and arthritis was higher than that reported by Florida and national data.
  
  
  CONCLUSIONS
  The findings presented in this paper are derived from one of only a few studies examining patterns of chronic disease among residents of both a rural and lower income geographic region. Overall, the prevalence of these conditions compared to the state and nation as a whole is elevated and calls for increased attention and tailored public health interventions.
authors.affiliation: Southeast Center for Research to Reduce Disparities in Oral Health, University of Florida, Gainesville, Florida 32610, USA. hlogan@dental.ufl.edu.
authors.forename: Henrietta
authors.initials: H
authors.lastname: Logan
authors.forename: Yi
authors.initials: Y
authors.lastname: Guo
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Dodd
authors.forename: Keith
authors.initials: K
authors.lastname: Muller
authors.forename: Joseph
authors.initials: J
authors.lastname: Riley
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D005006:Ethnicity; D005260:Female; D005431:Florida / Q000453:epidemiology; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D015995:Prevalence; D019035:Rural Health Services / Q000191:economics; D012737:Sex Factors